title: [Utility of the PET/CT in vulvar cancer management].
abstract: OBJECTIVE
  To describe the clinical impact of PET/CT in the management of patients with vulvar cancer.
  
  
  METHODS
  Retrospective analysis of 13 PET/CT studies with (18)F-FDG (6 staging and 7 suspected recurrence) corresponding to 10 patients diagnosed with vulvar cancer by biopsy, with a mean age of 64.5 years. The preoperative PET/CT study was analyzed qualitatively according to the lesion region. Surgical excision was carried out, covering all the suspected areas according to the PET/CT study. This was compared with the histopathologic analysis.
  
  
  RESULTS
  Abnormal vulvar PET/CT uptake was found in 9 out of the 13 studies and invasion of adjacent structures in 5 of them (urethra, perineal, vagina). The inguinal-femoral lymph nodes were considered as affected in 3 studies and one pelvic lymph node was also affected. Four of the studies had extralymphatic involvement: 3 in lung and 1 in ischiorectal fossa. The PET/CT showed a 100% sensitivity for the detection of the vulvar lesion in squamous cell carcinomas and 60% in non-squamous cell ones. There was a false positive result for local invasion due to urine contamination. One of the studies with lung metastases was related to a synchronous breast tumor. All the pathological lymph node levels detected in the PET/CT study were confirmed in the histopathology study. No new lesions were identified by surgery. PET/CT changed the therapeutic management in 8/13 studies (61.5%).
  
  
  CONCLUSIONS
  PET/CT is postulated as a useful imaging test for the management of vulvar cancer, mainly in the identification of nodal metastases. It may affect both surgical planning and clinical management. Larger series are needed to confirm our findings.
authors.affiliation: Servicio de Medicina Nuclear, I.T.S.S.-MD Anderson Cancer Center, Madrid, España. Electronic address: virginiapeirov@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Peiró
authors.affiliation: Servicio de Ginecología Oncológica, MD Anderson Cancer Center, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Chiva
authors.affiliation: Servicio de Oncología Médica, MD Anderson Cancer Center, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: González
authors.affiliation: Servicio de Oncología Médica, MD Anderson Cancer Center, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Bratos
authors.affiliation: Servicio de Ginecología Oncológica, MD Anderson Cancer Center, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Alonso
authors.affiliation: Servicio de Oncología Médica, MD Anderson Cancer Center, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Márquez
authors.affiliation: Servicio de Oncología Radioterápica, MD Anderson Cancer Center, Madrid, España.
authors.forename: N
authors.initials: N
authors.lastname: Carballo
authors.affiliation: Servicio de Medicina Nuclear, I.T.S.S.-MD Anderson Cancer Center, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Alonso-Farto
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Cáncer de vulva; Manejo terapéutico; Metástasis ganglionares; Nodal metastasis; PET/CT; PET/TC; Therapeutic management; Vulvar cancer